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Human Immunodeficiency Virus (HIV), which causes Acquired Immune Deficiency Syndrome (AIDS), has become one of the most burdensome diseases worldwide since its discovery nearly 30 years ago. (UNAIDS, 2008)
Access to adequate housing profoundly affects the health of people who are at risk for or living with HIV. In fact, housing status predicts the probability of HIV risk. Homeless persons face enormous pressures of daily survival needs that supersede efforts to reduce HIV risk as well as multiple barriers to risk reduction. Among persons at highest risk for HIV infection (due to drug injection or unprotected sex), those without homes are significantly more likely to become infected with HIV over time. As a corollary, housing can also be used as a HIV reduction measure. Access to housing improves access and adherence to antiretroviral medications, which lower viral load and reduce the risk of transmittance. Proven risk reduction interventions are less effective amongst homeless/unstably housed persons – including counseling, safe needle exchange and other behavioral interventions. Well-constructed houses have better access to water and better quality flooring, providing beneficiaries with improved sanitation. The reduction of humidity and air drafts will also improve overall health.
People who improved their housing status reduced risk factors by one half while persons whose housing status worsened were 4 times as likely to exchange sex. Homeless or unstably housed people living with HIV/ AIDS (PLWHA) were 3 times more likely to be outside the reach of medical care than housed PLWHA. According to National AIDS Housing Coalition (NAHC) housing status has been directly related to increased access to healthcare, increased levels of antiretroviral treatment adherence and mental health. It also is attributed to decreased individual risky behavior (with substance abuse and sexual promiscuity), viral loads, and mortality.
HIV housing interventions prevent new infections and decrease the use of expensive emergency and hospital services.
According to NAHC, Action to meet HIV housing needs costs far less than inaction, and is a wise use of limited public resources.
Homelessness is expensive and deadly:
• People coping with homelessness are frequent users of expensive crisis services including shelters, jails, and avoidable emergency and hospital care.
• People living with HIV/AIDS who are unstably housed lack ongoing HIV care and rely more on emergency and acute care. They have poorer health outcomes and don’t live as long.
• People with HIV who are homeless are 2 to 3 times more likely to use an emergency room and to have a detectible viral load than those in stable housing
Improved housing stability reduces overall public expense:
• Housing assistance for people with HIV who are homeless improves their health outcomes and dramatically reduces emergency and inpatient health services, criminal justice involvement, and other crisis costs.
• More stable housing for people with HIV has been shown to reduce emergency medical visits by 35% and hospitalizations by 57%.
• Housing assistance leads to savings in avoidable health services that more than offset the costs of the housing intervention.